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� <� �_� �4%"=�4 U'�+:5i THE �:_I )`;' LiF �_�k'Ul li i r�l�-4'�'._�-`� ;��'r' �_i�_i� <br /> i•: j ``� `�'� � b I C CITY OF dlt�t7D -- BiTJ:LDTNG PEI�l�iTT A�`PI,zCA'I.`YtIN <br /> ' � ���� 1 <br /> Total Fee: $ � --- -- -- ' llate R�ceiv�d: <br /> Date AoDroved : ` <br /> Ezxte�'�d av. l �`i <br /> ' �E�IT11.'��: � ( <br /> A�.L I2TFOI�23I1TSC7N MUS�' �h susMzz��:n zrt r�`Tr� B�'or,� �r�ax �vz�r w�:�z� �r �rz�cx� <br /> (Sep C'�eck-af� L�st Enc�losed) • <br /> ',I�HE 11P.L'�ZC'�3�I: :�5: f��rc)_e ane) Qt�TN�R s�r COrITRA�TOFi <br /> J�$ ST�'L ADDRESS: ���� ��������.., ��'�CL'� �.�, � Z�P� ��� � ��I <br /> i <br /> (wor}c) <br /> , � <br /> cilii�i� uz'� u:�iNZ'..1Z: �0 J � � �C�G� ��l I/1 �� �����' PHC]NE: (home) `7� �� ��� �`�� <br /> n <br /> MA3'zsx� ����s , ������_=����1��� ��cc���C� czs�Y: f�'t � �.1 °��zz�-� �� `�«_� <br /> � <br /> coN�c�oz�=_ �,�2��G�'�P�FT ------- - ��or�: ��/- ��� � -- <br /> j�3.P.T7,r�r� r�.Unx�ss: 3//,�!5���'�/tiiG �l iiL �� cirY:_/`%�i�l_S zz�: S S��J C _ <br /> ST�ST� �TC�:I'7SE: � OCD___ a_���. . <br /> IiRCHI�CT/I:rtc,INEYst: __ PIIONE: <br /> MAY�22�G r�DDRESS: � CZTX: Z1�'- � <br /> �IAME: FZEGTS�'R.Aa.'XaN ��- -- . <br /> �'YFE OF WORK: New Addition A�cessor--y Stzucture M��'� <br /> l7�to �iemodei/al�eration�__ Renova�e Land Alte��tion� <br /> ,�^ , �. <br /> � ���, � ,�t ,. � . <br /> PROJ�USED Wc7Rfi (describ� in deta�.l) - �I�� (1M�G- I-' ' G�-- �-ti'� �' %� „�.-/ �G" '� <br /> � <br /> � ,�-��� ��ti�, ,_,�'� � Jr L <br /> STO1�L'S: SQ. F�ET �F L'gC�1 F�.UOX: <br /> NO. OP SEDKt70MS: Gr�1'1.i�,GE ST�L7.S: ATT. DET. <br /> EST�SATm CC3NSTRIICTION V1s.LI7ATZQR (�s clnc�.�ng �and 1 : S � � <br /> I hezeby apply tor a buil.d�.ng' p�rm.i� �.nd I acknvwledge that th� :infoz�na�i or� <br /> abc�v� i»s �omp7.ete and accuz'a�e; th�� th� wdrk wiZl be �.n con£ox�'cance with th� <br /> os'dinances anc3 c�d�s o� the C�.�y and wi�:► the State Suilding CQde: that Z <br /> uAd��stand this �.s no� a permi� and wozk is nc�t to stast w�.thout a pezzu�.t; a�d <br /> th$t the work will be �.n accordanc� with the apnroved �la.si_ • <br /> �`�' ,,��� i� ,/ . _-- ._� ' - ---. :- L;� •-� — � � <br /> G�,�,�.- �', ,�,�,: DA'2�� � ; <br /> AI2P�ZCIIN'1"S SIG2I�1TiTFi�: �, <br /> ' s'�cN_�l .�.��i-�. /.�.L/�!�j ., <br />